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APEA Predictor Exam Missed
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What is the biggest side effect of colchicine? ✔✔diarrhea How would you describe the appearance of molluscum contagiosum? ✔✔papules that are umbilicated and contain a caseous plug How do we treat a broken clavicle in an infant? ✔✔no treatment; it should heal on it's own At what week of pregnancy is the uterus palpable just above the pubic symphysis? ✔✔week 12 At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? ✔✔week 16 At what week of pregnancy is the fundus of the uterus at the umbilicus? ✔✔week 20 At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? ✔✔week 28 At what week of pregnancy is the fundus just below the xiphoid process? ✔✔week 34 Increased sweat production is a sign of what endocrine disorder? ✔✔hyperthyroidism What is Paget's disease? ✔✔there is localized increased bone turnover and blood flow resulting in the breakdown of bone and replacing it with weakened and highly vascular bone putting the indiv at increased risk of fractures
How do we treat Paget's diseease? ✔✔bisphosphonates How should pregnant women wear their seatbelt? ✔✔with the shoulder strap like a normal person and then the groin strap below the belly and across the hips What is another name for fifth disease? ✔✔parvovirus aka slapped cheek disease aka erythema infectiosum Which type of prevention are vaccinations? ✔✔primary When should patients begin antiretroviral therapy for HIV infection? ✔✔as soon as it is detected, even if in the acute phase What are the first generation antihistamines? ✔✔diphenhydramine (benadryl) and chlorpeniramine (actifed) What are s/s of the secondary stage of syphilis? ✔✔rash on hands and feet, lymphadenopathy, fever What is the recommended treatment for chronic bacterial prostatitis? ✔✔a fluoroquinolone (cipro or levo) + bactrim What is the recommended treatment for acute prostatitis? ✔✔cipro (if not STI related) or ceftriaxone What are s/s of an intraductal breast papilloma? ✔✔clear to bloody unilateral nipple discharge (bilateral is usually benign), and also a wart like lump palpated in the nipple area If a patient has GABHS but has an allergy to penicillins, what is the second line option? ✔✔first generation cephalosporins, unless the allergy is severe, then you would consider macrolides like a - mycin
If a patient on coumadin's INR is 4.1-5.0, what should you do? ✔✔hold one dose then decrease the weekly dose by 10% If a patient's INR is greater than 5, what should you do? ✔✔consult cards, likely would hold two doses then decrease the weekly dose An anorexic patient will have a BMI of what? ✔✔less than 18 What is primary amenorrhea? ✔✔when the patient has never gotten their period before (there is an absence of menarche) but they have all of their secondary sex characteristics Secondary amenorrhea is a lack of menses after _________ of not having a period; but you have had one before ✔✔3 months What do we need to do first when a patient comes in with secondary amenorrhea? ✔✔rule out pregnancy Anorexia can put you at risk for what? ✔✔osteoporosis, amenorrhea, cardiac damage Amenorrhea is considered a risk factor for what? ✔✔osteoporosis What is the best indication of an anorexic patient doing better? They tell you they are eating more, they have weight gain, or they get their period back? ✔✔they get their period back If a pregnant woman has syphilis, what should we do? ✔✔treat it with penicillin while she is pregnant because there is risk for spontaneous abortion What is the causative organism of mastitis? ✔✔staph
What is the first line treatment for mastitis? ✔✔keflex (a cephalosporin). If that doesn't work, then try another antibiotic. If that STILL doesn't work, then refer for an ultrasound What is one of the biggest risk factors for cervical cancer? ✔✔numerous sexual partners Preeclampsia most commonly shows up at what time in pregnancy? ✔✔around week 20 How do we treat UTIs in a pregnant woman? ✔✔can either do penicillin, cephalosporin, or a macrolide (can NOT do doxy or a fluoroquinolone) When do fibrocystic breasts tend to flare up and cause tenderness and lumps? ✔✔about 10 days before menses What can be a sequelae of an ectopic pregnancy? ✔✔pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis) What is the Coomb's test and when is this completed? ✔✔test given 8 weeks in to pregnancy to determine a woman's RH compatibility If a patient's Coomb's test is positive, what do we do? ✔✔nothing, she is RH positive so we do not need to treat If a patient's Coomb's test is negative, what do we do? ✔✔give rhogam at 28 weeks and 72 hours after birth What is the only form of non-hormonal contraception other than barrier methods such as condoms? ✔✔IUD The vaginal ring for contraception must be taken out how often? ✔✔every 3 weeks
When does placental abruption most commonly occur? ✔✔in the third trimester What is the major difference in symptomalogy between placenta abruptio and placenta previa? ✔✔a placental abruption is painful whereas placenta previa is painless If a pregnant woman comes in with painless vaginal bleeding, what should we be considering? ✔✔placenta previa What is the recommended treatment for polymyalgia rheumatica? ✔✔steroids Patients with SLE are going to have what abnormal labwork? ✔✔elevated ESR and CRP How do we treat lupus flares? ✔✔steroids What are common sequelae of fibromyalgia? ✔✔insomnia and depression What is a great treatment option for fibromyalgia? ✔✔amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression How is fibromyalgia diagnosed? ✔✔when at least 8 out of 11 points bilaterally are tender to touch and the symptoms have lasted longer than 3 months What is slipped capital femoral epiphysis? ✔✔when the femoral head of the hip is out of place What is the trendelenburg sign and when is it positive? ✔✔when the patient is standing straight and the pelvis on the unaffected side drops; this is a sign of a slipped capital femoral epiphysis What is the main characteristic of a slipped capital femoral epiphysis? ✔✔walking with a limp
SCFE is most common in which patient population? ✔✔adolescents What is legg-calve-perthe disease? ✔✔avascular necrosis of the femoral head due to a lack of blood supply Legg-calve-perthes disease is most common in which patient population? ✔✔young children What is the radiographic study of choice for the knee? ✔✔MRI What is the radiographic study of choice for the back? ✔✔x ray What is bursitis? ✔✔a fluid collection in the bursa of a joint How is bursitis treated? ✔✔a needle to instill intraarticular steroids and then pull off fluid Bursitis can be a __________ issue ✔✔recurrent The medical term for knock knees ✔✔genu valgum The medical term for bow legs ✔✔genu varum What is myasthenia gravis? ✔✔an autoimmune disorder that causes muscle weakness of the voluntary muscles Genu valgum is caused by a problem with what? ✔✔the medial collateral ligament; think valgum as in gum makes your knees stick together Genu varum is caused by a problem with what? ✔✔the lateral collateral ligament
How long do migraine headaches last? ✔✔ 4 - 72 hours How can we abort cluster headaches? ✔✔calcium or 100% oxygen application Which type of headaches come with lacrimation and sinus symptoms? ✔✔cluster headaches What does the apprehension test assess for? ✔✔used to assess for stability of the shoulder or knee; assesses for stability How does the parathyroid gland regulate calcium? ✔✔when parathyroid hormone is released, it pulls calcium out of the blood and into the circulation in response to hypocalcemia. it also increases absorption of calcium from the intestine What is the first line treatment for trigeminal neuralgia? ✔✔carbamazepine (tegretol) or amitriptyline. also want to do gabapentin or something for nerve pain What is the recommended treatment for Bell's palsy? ✔✔steroids and anti-virals How is the pain of trigeminal neuralgia vs temporal arteritis different? ✔✔in trigeminal neuralgia, the pain is like a shock hitting the side of your face whereas temporal arteritis is more like a headache What are the preventative treatment options for migraines? ✔✔beta blockers, amitriptyline, venlafaxine, topamax, valproate What is Addison's disease? ✔✔adrenal insufficiency; the patient will be low in cortisol and sodium but their potassium will be high What are s/s of Addison's disease? ✔✔bronze or discolored skin, salt cravings
a rare complication of pregnancy characterized by the abnormal growth of trophoblasts, the cells that normally develop into the placenta ✔✔molar pregnancy What bacteria is the leading cause of urethritis? ✔✔neisseria gonorrhea What is the most common cause of hypercortisolism? ✔✔excessive ACTH production How do we treat developmental hip dysplasia in a child under 6 months? ✔✔Pavlik harness; if older than 6 months may need surgery It is recommended that all children younger than __________ with sickle cell anemia take daily prophylactic antibiotics. What antibiotic is this? ✔✔5 years old; penicillin When can cervical cancer screening stop if no abnormal screening history is present? ✔✔age 65 When should breast cancer screening begin and end with a biannual mammogram? ✔✔age 50- 74 When should colorectal cancer screening stop? ✔✔age 85 Who qualifies for a low dose CT scan for lung cancer screening purposes? ✔✔age 50-80 years anyone who currently smokes or has stopped smoking within the last 5 years What does an ASC-US (atypical squamos cells of undetermined significance) pap smear result necessitate? ✔✔Do HPV testing with this. If positive, repeat in one year if age 21-24 or send for colposcopy if older than 25. If negative, repeat pap in 3 years. Which pap smear result is considered to be HPV positive? ✔✔LSIL
